OBJECTIVES: Atrial fibrillation (AF) is a significant risk factor for stroke, often leading to severe disability and substantial healthcare costs. Implementing app-based screening programs for AF has the potential to reduce stroke incidence and associated costs. This study assesses the impact of a systematic AF screening, by photopethysmographic detection by smartphone on the societal costs of stroke in Germany (DE), the Netherlands (NL), and Poland (PL).

METHODS: Economic evaluation for population 65+ was carried out from societal perspective, including direct and indirect costs and loss of productivity, using Markov modelling. The hypothetical participants pass through various model-stages with transition probabilities determined by literature. For a hypothetical cohort of 10,000 participants, direct and indirect healthcare costs of the remaining lifetime were set in relation to the related QALY. Influence of the assumptions on overall results were evaluated by sensitivity analyses.

RESULTS: The cost of a stroke in the first and the following years were estimated DE: 21,060€; 6,231€, NL: 27,069€; 7,921€; PL: 9,800€, 2,811€. The difference in coverage was with only direct costs versus inclusion of indirect costs and productivity loss per participant DE: -5.63€; 67.54€, NL: -15.44€; 23.26€, PL: -19.90€; 6.25€.

Sensitivity analyses resulted that variation of the ratio of first year indirect costs to direct costs from 0.3 to 0.6 yielded changes of the contribution from 35.09€ to 75.81€ (DE), 20.77€ to 56.98€ (NL) and 2.69€ to 25.28€ (PL). Scaling the assumption for subsequent years from 50% to 150% (100%=base case) yielded result changes from 47.78€ to 86.30€ (DE), 13.33€ to 33.19€ (NL) and -0.42€ to 12.93€ (PL).

CONCLUSIONS: AF screening programs in Germany, the Netherlands, and Poland may significantly reduce the societal costs of stroke by decreasing stroke incidence and related healthcare expenditures. These programs are cost-effective and should be considered for wider implementation to enhance economically efficient public health outcomes.